Bone mass and soft tissue compartments in adolescents with anorexia nervosa.
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Absorptiometry, Photon↗
Biomedical subjects
J Harrison
Publications and source records attributed to J Harrison.
Aprotinin therapy in cardiac operations: a report on use in 41 cardiac centers in the United Kingdom.
Aprotinin, a serine protease inhibitor, has recently been shown to reduce blood loss in cardiac surgical patients. Data on the safety and efficacy of aprotinin therapy administered to 671 cardiac surgical patients in 41 United Kingdom cardiac surgical units have been submitted to interim analysis. The patients studied were in high-risk categories for excessive bleeding, including 457 redo operations and 79 patients with active infective endocarditis. Overall mortality was 12% in redo cases and 5.1% in first-time operations. Adverse events were reported in only 20 patients (3%). Median blood loss at 24 hours after operation was 400 mL, and median transfusion volume throughout the operative and postoperative period was 2 units. These data confirm that the use of aprotinin therapy in high-risk cardiac surgical patients is associated with a low incidence of adverse events.
Adolescent↗
Determining residual urine volumes using a portable ultrasonographic device.
Residual urine volumes of 24 men with neurogenic bladder dysfunction were repetitively assessed 400 times with the BVI-2000 BladderScan portable ultrasonographic device prior to 100 episodes of intermittent catheterization. By comparing each examiner's first ultrasonographic measurement of urine volume with the catheterized urine volume, the mean error of the ultrasonographic measurements was -26mL (-11%) and the mean absolute error was 44mL (22%). The ultrasonographic measurements detected the presence of residual urine volumes of > or = 100mL with a sensitivity of 90% and a specificity of 81%. In the subset of catheterization episodes in which the catheterized urine volumes were < or = 200mL, the mean error of the ultrasonographic measurements was -15mL (-9%), the mean absolute error was 37 mL (28%), and the sensitivity and specificity were 77% and 81%, respectively. There was no clear advantage in using the average or maximum of two repeated ultrasonographic measurements over using each examiner's first ultrasonographic measurement alone. Increased examiner experience did not significantly decrease the errors encountered.
Adult↗
Atypical adenomatous hyperplasia of the prostate: morphologic criteria for its distinction from well-differentiated carcinoma.
Atypical adenomatous hyperplasia (AAH) is a localized proliferation of small glands within the prostate that may be mistaken for carcinoma. To determine the diagnostic criteria for separating AAH from carcinoma, seven observers independently evaluated 54 selected lesions from 44 transurethral resection specimens. Three patterns of glandular proliferation were observed, all arising in association with nodular hyperplasia: AAH (38 foci), atypical small acinar proliferation of uncertain significance (eight foci), and well-differentiated carcinoma (eight foci). Of 24 architectural and cytologic features evaluated, the following were useful in separating these three patterns: variation in nuclear size (14%, 22%, and 25%, respectively), mean nucleolar diameter (0.69 micron, 1.43 microns, and 1.78 microns, respectively), largest nucleolar diameter (mean, 1.66 microns, 2.71 microns, and 2.81 microns, respectively), percentage of nucleoli greater than 1 micron in diameter (17.6%, 58.1%, and 77.5%, respectively), crystalloids within suspicious glands (16%, 13%, and 75%, respectively), luminal basophilic mucinous secretions, infiltrative borders, discontinuity of the basal cell layer in AAH (compared with complete absence in carcinoma; shown with basal cell-specific anti-keratin monoclonal antibody 34 beta E12 immunostaining), and intact basement membrane in AAH (compared with discontinuity in carcinoma; shown with type IV collagen immunostaining). Features that could not reliably separate AAH from carcinoma included lesion shape, circumscription, multifocality, average gland size, variation in gland size and shape, nuclear shape, chromatin pattern, and amount and tinctorial quality of cytoplasm. Although the biologic significance of AAH is uncertain, its light microscopic appearance and immunophenotype allow it to be distinguished from carcinoma in most cases.
Adenoma↗
The effect of BAY u 3405, a thromboxane receptor antagonist, on prostaglandin D2-induced nasal blockage.
BACKGROUND: Nasal lavage and challenge studies in allergic rhinitis implicate prostaglandin (PG) D2 in the genesis of nasal blockage. PG D2 is known to act via at least two receptors, the thromboxane prostanoid receptor and the PG D2 prostanoid (DP) receptor; the lower airway effects are mediated chiefly by the TP receptor. The receptor involved in the genesis of PG D2-induced nasal blockage is unknown. BAY u 3405 is a potent selective competitive TP receptor antagonist, which inhibits the lower airway response to PG D2, and shifts the dose-response curve to the right by up to 16-fold. METHODS: The efficacy of a single oral dose of 20 mg of BAY u 3405 was examined in comparison with PG D2 nasal insufflation in a randomized, double-blind, placebo-controlled crossover study, with objective measurement of nasal resistance by active posterior rhinomanometry. RESULTS: BAY u 3405 afforded no protection against PG D2-induced nasal blockage. CONCLUSIONS: This suggests that PG D2-induced nasal blockage may be mediated by the DP receptor rather than the TP receptor and that TP receptor antagonists are unlikely to be of benefit in the treatment of allergic rhinitis. In vivo investigation with specific potent DP receptor antagonists is awaited.
Adult↗
Coloured speech perception: is synaesthesia what happens when modularity breaks down?
Evidence was reported earlier from a single case that chromatic-lexical (CL) synaesthesia was a genuine phenomenon. A study is presented in which nine subjects were tested who also reported having coloured hearing. The following questions were addressed: (a) were these cases also genuine (ie consistent over time), (b) were they truly lexical, or rather variants of this condition, such as chromatic-graphemic (CG) or chromatic-phonemic (CP) synaesthesia, (c) did the experimental subjects show any commonalities between them, and (d) were they able to give information on a standard questionnaire about the phenomenology and ontogenesis of the condition? Subjects were asked to describe the colour sensation experienced on hearing items from a list of 130 words, phrases, and letters. The experimental group were not informed of any retest, but were retested more than one year later. A control group (n = 9), matched for IQ, memory, age, and gender, were read the same list and asked to associate a colour with each list item. They were informed at the time of testing that they would be retested on a sample of items from the list a week later. 92.3% of the responses of the experimental group when retested one year later were identical to those given in the original test, compared with only 37.6% of the control subjects' responses (retested one week later). This confirmed the genuinneess of these nine cases. All nine experimental subjects showed CG synaesthesia, none showing either CL or CP synaesthesia. Among the experimental group, some consistency was found in the colours evoked by hearing specific letters, suggesting the condition has a neurological basis.(ABSTRACT TRUNCATED AT 250 WORDS)
Acoustic Stimulation↗
Effects of changing the pattern of sickness absence referrals in a local authority.
The high costs of sickness absence in North Tyneside Metropolitan Borough Council prompted a review of the system of referral of cases of long-term sickness absence to their occupational health service for opinion about fitness to work. Earlier and more consistent referral of these employees produced reductions in average lengths of sickness absence. Time off before medical retirement was reduced from 72 weeks to 53 weeks, and time off before returning to work was reduced from 40 weeks to 25 weeks. Exact figures of the financial savings could not be calculated, but the estimated saving was 760,000 pounds in the first year. Although the occupational health service was not responsible for the whole of this saving, it played an important role in the exercise. It was concluded that earlier referral of employees with long-term sickness absence enabled decisions about returning to work to be made sooner, thus saving large amounts of money.
Absenteeism↗
Injury surveillance in Australia.
The development of injury surveillance systems in Australia is described from a public health perspective at the national level. Injury surveillance systems have undergone significant changes in recent years and further developments are planned. Three phases or generations are distinguished, each with distinctive features, advantages, and disadvantages. The first generation system was based on by-product data from routine mortality and morbidity statistics. The second generation system was specifically designed for injury surveillance, mainly using data collected for this purpose in hospital accident and emergency departments. A third generation of public health surveillance systems for injury control is now being developed for Australia. In developing a third generation system, a middle course is being charted. The number of data items and the complexity of classification for routine surveillance are mid-way between those of the first and second generation systems.
Australia↗
Aldehyde disinfectants and health in endoscopy units. British Society of Gastroenterology Endoscopy Committee.
Summary of main recommendations(1) Glutaraldehyde, used in most endoscopy units in the United Kingdom for the disinfection of flexible gastrointestinal endoscopes, is a toxic substance being an irritant and a sensitiser; symptoms associated with glutaraldehyde exposure are common among staff working in endoscopy units.(2) The Control of Substances Hazardous to Health Regulations 1988 (COSHH) obliges the employer to make a systematic assessment of risk to staff of exposure to glutaraldehyde and institute measures to deal effectively with exposure.(3) At present glutaraldehyde remains the first line agent for the disinfection of flexible gastrointestinal endoscopes. Other agents are being developed; a standard means of assessment for flexible endoscope disinfectants should be devised.(4) Equipment and accessories that are heat stable should be sterilised by autoclaving; disposable accessories should be used wherever possible.(5) Flexible gastrointestinal endoscopes should be disinfected within automated washer/disinfectors; trays, bowls or buckets for this purpose are unacceptable.(6) Local exhaust ventilation must be used to control glutaraldehyde vapour. Extracted air may be discharged direct to the atmosphere or passed over special absorbent filters and recirculated. Such control measures must be regularly tested and records retained.(7) Endoscope cleaning and disinfection should be carried out in a room dedicated to the purpose, equipped with control measures to maintain the concentration of glutaraldehyde vapour at a level certainly below the current occupational exposure standard of 0.2 ppm and preferably below the commonly used working limit of 0.1 ppm. Sites other than the endoscopy unit where endoscopy is regularly performed, such as the radiology department, should have their own fully equipped cleaning and disinfection room.(8) COSHH limits the use of personal protective equipment to those situations where other measures cannot adequately control exposure. Such equipment includes nitrile rubber gloves, apron, chemical grade eye protection, and respiratory protective equipment for organic vapours.(9) Monitoring of atmospheric levels of glutaraldehyde should be performed by a competent person such as an occupational hygienist; the currently preferred method of sampling uses a filtration technique, the commercially available meters being less reliable.(10) Health surveillance of staff is mandatory; occupational health records must be retained for 30 years.(11) Endoscopy staff must be informed of the risks of exposure to glutaraldehyde and trained in safe methods of its control. Only staff who have completed such an education and training programme should be allowed to disinfect endoscopes.(12) The unsafe use of glutaraldehyde has significant health and legal consequences; the safe use of glutaraldehyde may have revenue consequences that contribute significantly to the cost of gastrointestinal endoscopy.
Aldehydes↗
Human coagulation factor IX: assessment of thrombogenicity in animal models and viral safety.
Thromboembolic complications associated with prothrombin complex concentrate treatment may be related to the high levels of factors II and X in these products. We report here results from preclinical safety studies with a human coagulation factor IX product (AlphaNine; Alpha Therapeutic Corp., Los Angeles, Calif.) that contains no detectable factor II or VII and less than 10 units of factor X/100 units of factor IX. This product was manufactured from virally inactivated factor IX complex with a barium citrate adsorption step followed by affinity chromatography yielding factor IX concentrate with a specific activity of about 86 factor IX units/mg protein. Electrophoresis and immunoblot analysis indicated that the factor IX represents about 65% of the protein in this product. The virus inactivation step incorporated into the manufacturing process (incubation with n-heptane at 60 degrees C for 20 hours) was shown to inactivate at least 8.6 logs of type 1 human immunodeficiency virus. The barium citrate adsorption and affinity chromatography steps were found to remove 2.0 logs of the marker virus, vaccinia, and the DEAE ion-exchange chromatography used to produce factor IX complex was found to remove 1.4 logs of the marker virus, Sindbis. Analysis of three separate manufacturing lots with the polymerase chain reaction revealed no evidence of hepatitis C virus. The purified factor IX was nonthrombogenic when tested at doses of 450 units/kilogram in a rabbit stasis (Wessler) model, whereas the prothrombin complex concentrates were found to be thrombogenic at doses of less than 50 units/kg. There was no evidence of DIC in a porcine model after infusion of 200 units/kg of coagulation factor IX, as manifested by negative fibrin monomer tests, the absence of fibrin in blood vessels at autopsy, little or no change in prothrombin times and partial thromboplastin times, and only moderate decreases in platelet levels after infusion.
Animals↗
A memorial to Joseph J. Harrison III.
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History, 20th Century↗
Kinetics of superoxide dismutase- and iron-catalyzed nitration of phenolics by peroxynitrite.
Superoxide dismutase and Fe3+EDTA catalyzed the nitration by peroxynitrite (ONOO-) of a wide range of phenolics including tyrosine in proteins. Nitration was not mediated by a free radical mechanism because hydroxyl radical scavengers did not reduce either superoxide dismutase or Fe3+EDTA-catalyzed nitration and nitrogen dioxide was not a significant product from either catalyst. Rather, metal ions appear to catalyze the heterolytic cleavage of peroxynitrite to form a nitronium-like species (NO2+). The calculated energy for separating peroxynitrous acid into hydroxide ion and nitronium ion is 13 kcal.mol-1 at pH 7.0. Fe3+EDTA catalyzed nitration with an activation energy of 12 kcal.mol-1 at a rate of 5700 M-1.s-1 at 37 degrees C and pH 7.5. The reaction rate of peroxynitrite with bovine Cu,Zn superoxide dismutase was 10(5) M-1.s-1 at low superoxide dismutase concentrations, but the rate of nitration became independent of superoxide dismutase concentration above 10 microM with only 9% of added peroxynitrite yielding nitrophenol. We propose that peroxynitrite anion is more stable in the cis conformation, whereas only a higher energy species in the trans conformation can fit in the active site of Cu,Zn superoxide dismutase. At high superoxide dismutase concentrations, phenolic nitration may be limited by the rate of isomerization from the cis to trans conformations of peroxynitrite as well as by competing pathways for peroxynitrite decomposition. In contrast, Fe3+EDTA appears to react directly with the cis anion, resulting in greater nitration yields.
Animals↗
A flat earth syndrome.
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Administrative Personnel↗
Talkin' about a revolution.
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Employment↗
Defining and predicting tracheoesophageal puncture success.
There is considerable variability in the reported success rates of tracheoesophageal puncture due, in part, to the lack of a clear definition of success and a paucity of knowledge about factors that determine success. In this article, we define success on a continuum with the use of a 15-point rating scale that incorporates aspects of use and quality of speech and ability to care for the fistula and prosthesis. We suggest a cutoff score for functional and nonfunctional speakers. We define immediate and short- and long-term success. Variables related to the patient, clinician, surgical procedure, and extent of disease were subjected to a multiple regression analysis to determine which predicted success. Overall success was predicted by greater clinician expertise, younger patient age, and better patient health. We discuss the use of the rating scale and an equation to predict success.
Adult↗
Phase II trial of 5-fluorouracil, high-dose leucovorin calcium, and dipyridamole in advanced prostate cancer.
To examine the effect of altering intracellular folate pools on the efficacy of 5-fluorouracil (FUra) in the treatment of advanced prostate cancer, we performed a phase II trial of FUra (300-370 mg m-2 day-1 x 5 as an i.v. bolus) combined with high-dose folinic acid (500 mg m-2 day-1 x 5.5 days by continuous i.v. infusion) and dipyridamole (75 mg p.o. every 6 h x 5.5 days) administered on a 28-day schedule in patients with stage D2 disease. A group of 13 patients have been treated. The median age was 68 years (range 48-78 years); the performance status ranged from 50% to 90%. Among 12 evaluable patients, there were no objective responders; the median time to progression was 1.9 months. Median survival after entry on this trial was 8.6 months. Treatment with FUra, high-dose folinic acid and dipyridamole was well tolerated. Only one episode each of grade 3 leukopenia, granulocytopenia, and thrombocytopenia was observed. These results suggest that, despite previous trials demonstrating activity for FUra in stage D2 prostate cancer, this disease may be relatively resistant to fluoropyrimidines and, thus, less amenable to biochemical modulation with high-dose folinic acid and dipyridamole.
Aged↗
An investigation of the relationship between microbial and particulate indoor air pollution and the sick building syndrome.
The sick building syndrome has been the subject of research for approximately 10 years. Although it is often suggested that symptoms in office workers are due to circulating micro-organisms or particles, epidemiological studies investigating the relationship between them have been lacking. This cross-sectional study has combined medical and aerobiological assessments of offices in Great Britain and has found that, although airborne particulates and micro-organisms are unlikely to be the sole cause of the sick building syndrome, positive associations between symptom prevalence rates and levels of airborne viable bacteria and fungi within groups of buildings with similar ventilation systems, suggest a possible causal link that should be explored.
Air Microbiology↗